Dear Readers,

As we celebrate Recovery Month in September, it is our pleasure to announce a new partnership between the National Council for Community Behavioral Healthcare and Hazelden to publish the Addiction News Now. The National Council is committed to advocating for individuals with substance use and mental health problems and the providers that serve them. Hazelden, long recognized as a leader in the addiction treatment field, is engaged in an array of research and publishing endeavors to help people recognize, understand, and overcome addiction and closely related problems.

In the past, this newsletter has served as a way to share updates on federal advocacy efforts, new research findings, and other online resources that may be of assistance to you. Through the new National Council – Hazelden partnership, we look forward to continuing to provide you the latest news and updates that will help you to enhance the incredible work you do every day to serve individuals with substance use problems.

We welcome any comments or story suggestions for the Addiction News Now. Please email Mohini Venkatesh at MohiniV@thenationalcouncil.org, Senior Director, Public Policy at the National Council or Dean Peterson at dppeterson@hazelden.org, Director of the Center for Public Advocacy at Hazelden.

Best Regards,

Chuck Ingoglia, MSW
Vice President, Public Policy
National Council for Community Behavioral Healthcare

Marvin D. Seppala, M.D.
Chief Medical Officer
Hazelden

RESOURCES & REMINDERS

HHS Funding for SBIRT
HHS has announced the availability of up to $137 million, partly supported by the Affordable Care Act, to states to strengthen the public health infrastructure and provide jobs in core areas of public health. The funding includes up to $75 million to fund nine Screening, Brief Intervention, Referral and Treatment programs over the next five years. These programs will allow communities throughout the nation to provide more comprehensive substance abuse screening, secondary prevention, early intervention and referrals to treatment for people at higher risk for substance abuse. For a full list of grantees, click here.

Integration of Drug Abuse Prevention in Primary Care
The National Institute on Drug Abuse is requesting applications for an implementation research project to identify effective strategies and service delivery models for integrating existing evidence-based approaches to drug abuse prevention and treatment into primary care settings. Selected applicants will be awarded up to $500,000. Eligible applicants include government agencies, for profit and not-for-profit organizations. Deadline to apply is October 31. Read more.

September is Recovery Month; Online Resources & Essay Contest
Recovery Month spreads the positive message that behavioral health is essential to overall health, that prevention works, treatment is effective and people can and do recover. Recovery Month, now in its 22nd year, highlights individuals who have reclaimed their lives and are living happy and healthy lives in long-term recovery and also honors the treatment and recovery service providers who make recovery possible. Recovery Month promotes the message that recovery in all its forms is possible and also encourages citizens to take action to help expand and improve the availability of effective recovery services for those in need.

In recognition of Recovery Month 2011, the ATTC National Office, in partnership with Faces & Voices of Recovery (FAVOR) and National Alliance for Medication Assisted (NAMA) Recovery, invites individuals who have been supported by Medication-Assisted Treatment (MAT), such as utilization of methadone or buprenorphine for opioid addiction and acamprosate or naltrexone for alcohol adddiction, to share YOUR STORY of recovery. To learn more, including submission guidelines and information on prizes for top essays, click here. If you’d like to access other Recovery Month online resources, visit the National Recovery Month website.

IN THE NEWS

Clinical Support System to Educate Health Professionals on Proper Use of Opioid Medications
Through support from a SAMHSA grant, the American Academy of Addiction Psychiatry (AAAP) will be developing the Prescriber’s Clinical Support System which will train health professionals in two distinct areas: the appropriate use of opioid therapies to treat opioid-related addiction, and the safe use of opioid medications to treat chronic pain. In partnership with other organizations, such as the American Psychiatric Association and American Dental Association, AAAP hopes to assist a broad array of health professionals, not just prescribers. To learn more about this initiative, click here.

Study Highlights Value of 12-Step Recovery Programs to Young Women
A study conducted by researchers at Hazelden’s Butler Center for Research indicates that women ages 17-23 being discharged from inpatient treatment were just as likely as men in the same age group to attend 12 Step meetings and commit to 12 Step practices like obtaining a sponsor. 

The authors, Audrey A. Klein, Ph.D. and Valerie J. Slaymaker, Ph.D. of Hazelden’s Butler Center for Research, note that substance use disorder research has historically examined adult males, and while some studies are starting to study women, those that have looked at a specific age group have focused on older women or adolescents. “The study is important because it examines young women with substance use disorders in their late teens and early twenties, a population that has been extremely understudied by the research community,” says Klein.

Hazelden’s data analysis focused on 139 young women ages 17-23 who attended 12 Step-based residential treatment for a substance use disorder.  They were statistically compared to a sample of 237 young men who attended the same treatment program during the same time period.  The analysis showed young women were as likely as young men to attend 12 Step meetings and engage in prescribed 12 Step practices. Click here to read the abstract online.

NIDA Researchers Discover A New Mechanism Underlying Cocaine Addiction
Researchers have identified a key epigenetic mechanism in the brain that helps explain cocaine's addictiveness, according to research funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. The study, published in the January issue of the journal Science, shows how cocaine affects an epigenetic process (a process capable of influencing gene expression without changing a gene's sequence) called histone methylation. These epigenetic changes in the brain's pleasure circuits, which are also the first impacted by chronic cocaine exposure, likely contribute to an acquired preference for cocaine.

"This fundamental discovery advances our understanding of how cocaine addiction works," said NIDA Director Dr. Nora D. Volkow. "Although more research will be required, these findings have identified a key new player in the molecular cascade triggered by repeated cocaine exposure, and thus a potential novel target for the development of addiction medications." You can read more on NIDA’s website.

SAMHSA Report Finds Large Differences in Types and Severity of Substance Use and Mental Illness Across the States
A new SAMHSA report yields valuable insights on the scope and nature of behavioral health issues affecting the country. The report, based on the combined 2008 and 2009 National Surveys on Drug Use and Health, uses data drawn from interviews with 137,436 persons throughout the country to provide a state-by-state breakdown of 25 different measures of substance abuse and mental health problems, including illicit drug use, binge drinking, alcohol and illicit drug dependence, tobacco use, serious mental illness and major depressive episode.  Some of the report’s findings:

• The 10 states with the highest rates of past month illicit drug use among young people ages 12 or older were also the top 10 states for past month marijuana use in general (in alphabetical order -- Alaska, Colorado, District of Columbia, Hawaii, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island and Vermont).
• Fewer people seem to consider smoking a “great risk” compared to the 2007-2008 period.  Between the combined years 2007-2008 and 2008-2009, the perception of great risk from smoking one or more pack of cigarettes a day decreased in 14 states among those ages 12 to 17; in 31 states for those ages 18 to 25 and in 9 states for those 26 and older.  No states registered an increase in the perception of risk from heavy cigarette use.
• Eleven states showed declines in past year cocaine use among persons ages 12 or older between 2007-2008 and 2008-2009 (in alphabetical order -- Arizona, Arkansas, Georgia, Indiana, Kentucky, Maryland, Minnesota, Ohio, Oregon, Tennessee and Virginia).

The full report is available online.

GOVERNMENT AFFAIRS UPDATE

Joint Select Committee on Deficit Reduction Begins Negotiations; Advocates Seek to Protect Medicaid & Other Programs
The Joint Select Committee on Deficit Reduction  began its work of identifying at least $1.2 trillion in federal spending reductions. The committee is working on a tight timeline, with a Nov. 23 deadline for reaching agreement.

With the committee’s task spanning the entire range of federal spending and revenue, all healthcare programs are potentially at risk for cuts. Medicaid and Medicare in particular may be prime targets because they account for a large share of federal spending. Several proposals that have been put forth this year to reduce Medicaid spending would have devastating effects on the behavioral health safety net, including converting Medicaid to a block grant, creating “blended” federal match rates for each state, and repealing health reform’s Maintenance of Effort requirements.

Meanwhile, the National Council has joined forces with other advocates to stand up for safety net services:

• The National Council signed on to a letter by the Partnership for Medicaid encourages the Committee members to reject “arbitrary, across-the-board” Medicaid reductions and instead urges them to consider the Partnership’s proposed policy changes that would improve care quality and produce savings while also protecting beneficiaries’ access to care.
• The National Council has signed on to a letter being circulated by Families USA that urges the members of the committee to protect health care coverage for America’s most vulnerable families, especially those who depend on the Medicaid program for their lifeline.
   

VA Rule Affirms Role of Community Providers in Treating Veterans with Substance Use Disorders
As part of its efforts to end homelessness among veterans, the Department of Veterans Affairs (VA) this week issued a final rule clarifying that veterans with substance use disorders qualify for services under the Health Care for Homeless Veterans (HCHV) program. This program assists certain homeless veterans in obtaining treatment from non-VA community-based providers, where extensive outreach, physical and psychiatric health exams, treatment, referrals, and ongoing case management are provided. The final rule establishes regulations for contracting with community-based treatment facilities in the VA and clarifies that veterans with substance use disorders may qualify for the program.

A draft version of the new regulation was released on Dec. 20, with a 60-day public comment period. In the final rule, the VA responded to these public comments, writing that “treating substance use as a mental disorder is consistent with the generally accepted ‘disease model’ of alcoholism and drug addiction treatment, as well as the modern use of medical intervention to treat the condition. We believe that if a substance use disorder is a contributing cause of homelessness, then that disorder is serious; therefore, it is consistent to include such veterans in a program designed for ‘veterans suffering from serious mental illness, including veterans who are homeless’… [B]ased on our experience, we believe that the use of community resources is vital to the success of homelessness programs and in helping veterans return to the community as healthy, productive citizens.” The full text of the final rule is available online.

National Council Submits Comments on CMS Proposal to Cover Alcohol, Depression Screening
In a recent Decision Memo, CMS stated its intent to cover annual alcohol screening and behavioral counseling interventions (when indicated in the screening) for Medicare beneficiaries. The National Council’s comments  commend CMS for recognizing the importance of screening and providing brief interventions for individuals with at-risk alcohol behaviors. However, the proposal as written applies only to physicians practicing in a primary care setting. We also encourage CMS to strengthen the proposal by expanding the types of providers who may provide counseling, to include a licensed behavioral health providers working in primary care.

Hazelden Submits Comments to NIDA on Addressing Rates of Prescription Drug Abuse
The abuse of prescription drugs has reached epidemic status, and it is clear that a comprehensive strategy is needed to address the crisis.  The National Institute on Drug Abuse (NIDA) recently solicited input about a possible Surgeon General response to this issue.  The comments by Hazelden to NIDA focused on the need to further develop and expand access to prevention programming and to provide more training about addiction to health care professionals.  Topics to be included in such training include an understanding of addiction as a disease, the factors that put certain patients at risk for abuse and the unique needs of young people, who are abusing prescription drugs in alarming numbers. “What’s clear to us is the growing epidemic of prescription drug abuse, especially among our young people, cannot be effectively addressed through isolated efforts,” said Dean Peterson of Hazelden’s Center for Public Advocacy.  “It will take prevention programs, professional training, expert clinical care and greater advocacy for treatment and recovery to help and heal our communities.”

National Council Supports Coalition Recommendations for Essential Health Benefits
The National Council has joined several advocacy organizations in supporting the Coalition for Whole Health’s recommendations to the Department of Health and Human Services on what types of benefits should be included in the essential benefits package under the Affordable Care Act (ACA). The Coalition for Whole Health represents a coalition of national organizations advocating for improved coverage for and access to mental health and substance use disorder prevention, treatment, rehabilitation, and recovery services.

The ACA requires that all health insurance plans offered in the state health insurance exchanges – along with Medicaid benchmark plans – offer at least a minimum set of essential benefits. The essential benefit package must include substance abuse and mental health services at parity with other medical/surgical care, prevention services and rehabilitative services – yet the law did not specify specific services that must be covered.

The Coalition provided an array of detailed recommendations that emphasize the importance of comprehensive coverage including assessments; inpatient, outpatient treatment, and residential services; prescription drug access (including medication assisted treatment); emergency services; laboratory services, maternal and newborn services; pediatric services; rehabilitative and habilitative services; and prevention and wellness services and chronic disease management. To read the Coalition’s recommendations, click here.

Affordable Care Act Prevention Grants Will Support SBIRT, Tobacco Cessation
The Department of Health and Human Services has announced it is awarding $137 million for programs to strengthen local programs supported through the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC). Much of the funding for these grants came from the Prevention and Public Health Fund, created under the Affordable Care Act.

The new grant funding included:

• Nearly $5 million to help states and territories enhance and expand the national network of tobacco cessation quitlines to increase the number of tobacco users who quit. Quitlines are the toll-free numbers people can call to obtain smoking cessation treatments and services.
• Up to $75 million to fund nine Screening, Brief Intervention, Referral and Treatment programs over the next five years. These programs will allow communities throughout the nation to provide more comprehensive substance abuse screening, secondary prevention, early intervention and referrals to treatment for people at higher risk for substance abuse.

In a statement on the awards, HHS Secretary Kathleen Sibelius said, “more than ever, it is important to help states fight disease and protect public health. These awards are an important investment and will enable states and communities to help Americans quit smoking, get immunized and prevent disease and illness before they start.”

A full list of grantees is available online.